Changes of substance P, NGF and CGRP salivary levels among patients undergoing physical therapy

Pain is one of the most prevalent health conditions in the world. It is widely accepted that chronic pain persists beyond its biological usefulness and compromises the quality of life. Chronic pain is not only continuum of acute pain, but effect of functional and structural reorganization in central nervous system (CNS) and changes in perception and behaviour. The aim of our study was to investigate salivary levels of NGF, CGRP and substance P and assess changes in pain intensity among patients suffering from cervical spine pain or CSD-related headaches before and after physical therapy. Study group consisted of 86 patients. 44 were treated using McKenzie method and 42 of them underwent suboccipital relaxation therapy. To determine the salivary concentration of Substance P, CGRP, NGF the commercially available enzyme-linked immunosorbent assay kit were used. The intensity of pain was assessed using VAS score. In both groups we observed significant decrease in VAS score and Substance P concentration after treatment. In McKenzie group there was a significant increase in NGF level after therapy; the changes in CGRP level were not significant. In group undergoing suboccipital relaxation we found significant reduction of concentration of all investigated molecules: Substance P, CGRP and NGF. Both methods influence the conditions of patients through decrease in VAS score and changes in salivary levels of Substance P, CGRP and NGF. Further research is needed to completely elucidate the influence of McKenzie method and suboccipital relaxation on pain markers levels